I have been talking with OntarioMD and my EMR company about establishing on-line patient access to the chart and to my scheduler. Because our server is hosted at the hospital, there are additional security layers. Allowing and managing access is going to be very complicated; there are several organizations involved. I think this is something that may have to wait a bit.
I was told by my EMR company that giving patients access to the scheduler in my waiting room does not present the same logistic problems, and could be done fairly easily. This would be a simple scheduler, with booked spaces greyed out and available spaces blank.
When I look at flow in my office, I often see a little traffic jam at the front. My secretary is busy on the phone, and patients are waiting to book their next appointment. When they book, they can't see my scheduler, and it usually involves some negotiations because my secretary does not know the patient's timetable. Many people book airline flights on line; I don't think booking a medical appointment is going to be all that complicated. If it is done in the office, my staff can help as well.
The EMR company will lend me a PC, and will also give me a one pager for patients. I will put the PC in my waiting room, with the monitor visible to the secretary and to the patient. I will need a pad of paper and some golf pencils so people can write down their appointments. There will need to be some type of patient registration before they can use the scheduler; I'm not sure how that will work yet. We'll try it out and see if it works, sometimes in June. I don't know if there are other offices allowing patient self-booking in the waiting room.
In the future, maybe I can use my waiting room for something more interesting than waiting. Maybe patients can self-check in with a card swipe, and verify their information. If I need a patient to fill out a form (example, a Benign Prostate Hypertrophy questionnaire to see how things are, or a PHQ-9 questionnaire for depression), maybe that can be programmed to pop up when the patient checks in. They can go to another PC in a more private area, and fill that out. Perhaps I could have pre-programmed health information for their health condition for them to look at while they wait. This would also be really good for research; you could have questionnaires administered in the waiting room.
There has been some talk of having several FHT physicians all move to a big office, together with several of the Allied Health Professionals we'll be hiring. I think this type of set-up would work better in a big office.
We have a FHN meeting on May 29th. Several of my colleagues have experienced the same type of hardware/software issues that I have, which involve computers rather than the EMR software itself; at one office, the cleaners accessed the internet at night, and introduced a virus on a PC. We are looking at hiring someone to serve as a "Geek squad", to be on call for these type of issues, and to make sure the computers are properly maintained. We can use group funds for this, but I'm not sure what it will cost; we are going to get a quote.
I have been asked if I get paid by the EMR company for things like giving a tour of my office to colleagues, or for articles that have been published in the press. I talked to them about this pretty early on. I think it is reasonable for people to get paid for their time; what I decided to do instead is to have them deposit the money in a "research fund". I can think of several colleagues who have really good ideas; the fund will not be large enough to support a big research project, but perhaps it can supply a bit of seed money when required--sort of like planting for the future.